Peripheral seal for a ventricular partitioning device

ABSTRACT

This invention is directed to a partitioning device for separating a patient&#39;s heart chamber into a productive portion and a non-productive portion which is suitable for treating patients with heart disease, particularly congestive heart failure. The partitioning device has a reinforced membrane with outwardly biased members to help seal the periphery of the membrane against the wall of the patient&#39;s heart chamber. In one embodiment, the outwardly biased member is an expansive strand that extends between adjacent ribs of an expandable frame which reinforces the membrane. In another embodiment, the outwardly biased member is a hydrophilic body such as foam which swells upon contact with body fluid such as blood in the heart chamber. The reinforced membrane has a central hub with a distally extending support stem with a plurality of feet which extend radially from a centerline axis and preferably have ends that are aligned in a common plane. The ends of the pods which extend radially away from the centerline axis may be interconnected by flexible struts and/or webs.

FIELD OF THE INVENTION

The present invention relates generally to the field of treating heartdisease, particularly congestive heart failure, and more specifically,to a device and method for partitioning a patient's heart chamber and asystem for delivering the treatment device.

BACKGROUND OF THE INVENTION

Congestive heart failure (CHF) is characterized by a progressiveenlargement of the heart, particularly the left ventricle and is a majorcause of death and disability in the United States. Approximately550,000 new cases occur annually in the U.S. alone. As the patient'sheart enlarges, it cannot efficiently pump blood forward with each heartbeat. In time, the heart becomes so enlarged the heart becomesineffective as a pump and cannot adequately supply blood to the body.Even in healthy hearts only a certain percentage of the blood in apatient's left ventricle is pumped out or ejected from the chamberduring each stroke of the heart. The pumped percentage, commonlyreferred to as the “ejection fraction”, is typically about sixty percentfor a healthy heart. A patient with congestive heart failure can have anejection fraction of less than 40% and sometimes much lower. As a resultof the low ejection fraction, a patient with congestive heart failure isfatigued, unable to perform even simple tasks requiring exertion andexperiences pain and discomfort. Further, as the heart enlarges, theinternal heart valves such as the mitral valve cannot adequately close.An incompetent mitral valve allows regurgitation of blood from the leftventricle back into the left atrium, further reducing the heart'sability to pump blood forwardly.

Congestive heart failure can result from a variety of conditions,including viral infections, incompetent heart valves (e.g. mitralvalve), ischemic conditions in the heart wall or a combination of theseconditions. Prolonged ischemia and occlusion of coronary arteries canresult in myocardial tissue in the ventricular wall dying and becomingscar tissue. Once the myocardial tissue dies, it is less contractile(sometimes non-contractile) and no longer contributes to the pumpingaction of the heart. It is referred to as hypokinetic or akinetic. Asthe disease progresses, a local area of compromised myocardium may bulgeout during the heart contractions, further decreasing the heart'sability to pump blood and further reducing the ejection fraction. Inthis instance, the heart wall is referred to as dyskinetic. Thedyskinetic region of the heart wall may stretch and eventually form ananeurysmic bulge.

Patients suffering from congestive heart failure are commonly groupedinto four classes, Classes I, II, III and IV. In the early stages,Classes I and II, drug therapy is presently the most common treatment.Drug therapy typically treats the symptoms of the disease and may slowthe progression of the disease, but it can not cure the disease.Presently, the only permanent treatment for congestive heart disease isheart transplantation, but heart transplant procedures are very risky,extremely invasive and expensive and are performed on a small percentageof patients. Many patient's do not qualify for heart transplant forfailure to meet any one of a number of qualifying criteria, and,furthermore, there are not enough hearts available for transplant tomeet the needs of CHF patients who do qualify.

Substantial effort has been made to find alternative treatments forcongestive heart disease. For example, surgical procedures have beendeveloped to dissect and remove weakened portions of the ventricularwall in order to reduce heart volume. This procedure is highly invasive,risky and expensive and is commonly only done in conjunction with otherprocedures (such as heart valve replacement or coronary artery by-passgraft). Additionally, the surgical treatment is usually only offered toClass III and IV patients and, accordingly, is not an option for mostpatients facing ineffective drug treatment. Finally, if the procedurefails, emergency heart transplant is the only presently availableoption.

Mechanical assist devices have been developed as intermediate proceduresfor treating congestive heart disease. Such devices include leftventricular assist devices and total artificial hearts. A leftventricular assist device includes a mechanical pump for increasingblood flow from the left ventricle into the aorta. Total artificialheart devices, such as the Jarvik heart, are usually used only astemporary measures while a patient awaits a donor heart for transplant.

Recently, improvements have been made in treating patient's with CHF byimplanting pacing leads in both sides of the heart in order tocoordinate the contraction of both ventricles of the heart. Thistechnique has been shown to improve hemodynamic performance and canresult in increased ejection fraction from the right ventricle to thepatient's lungs and the ejection fraction from the left ventricle to thepatient's aorta. While this procedure has been found to be successful inproviding some relief from CHF symptoms and slowed the progression ofthe disease, it has not been able to stop the disease and is onlyindicated in patients with ventricular dissynchrony.

Other efforts to treat CHF include the use of an elastic support, suchas an artificial elastic sock, placed around the heart to preventfurther deleterious remodeling.

SUMMARY OF THE INVENTION

The present invention is directed to a ventricular partitioning deviceand method of employing the device in the treatment of a patient withheart disease and particularly congestive heart failure (CHF).Specifically, the device partitions a chamber of the patient's heartinto a main productive portion and a secondary non-productive portion.This partitioning reduces the total volume of the heart chamber, reducesthe stress applied to weakened tissue of the patient's heart wall and,as a result, improves the ejection fraction thereof. Moreover, theexpansive nature of the device improves the diastolic function of thepatient's heart.

A partitioning device embodying features of the invention has areinforced partitioning component with a concave, pressure receivingsurface which defines in part the main productive portion of thepartitioned heart chamber when secured within the patient's heartchamber. The reinforced partitioning component has a flexible membranethat forms the pressure receiving surface. The partitioning component ispreferably reinforced by a radially expandable frame component formed ofa plurality of ribs. The ribs of the expandable frame have secureddistal ends, which are preferably secured to a central hub, and freeproximal ends. The distal ends of the ribs are preferably secured to thecentral hub to facilitate radial self expansion of the free proximalends of the ribs away from a centerline axis. The distal ends of theribs may be pivotally mounted to the hub and biased outwardly or fixedto the hub. The ribs are preferably formed of material such assuperelastic NiTi alloy which allows for compressing the free proximalends of the ribs toward a centerline axis into a contractedconfiguration for delivery and self expansion when released fordeployment to an expanded configuration when released within thepatient's heart chamber.

The free proximal ends of the ribs are configured to engage andpreferably penetrate the tissue lining the heart chamber to bepartitioned so as to secure the peripheral edge of the partitioningcomponent to the heart wall and fix the partitioning component withinthe chamber so as to partition the chamber in a desired manner. Thetissue penetrating proximal tips are configured to penetrate the tissuelining at an angle approximately perpendicular to a center line axis ofthe partitioning device. The tissue penetrating proximal tips of theribs may be provided with barbs, hooks and the like which preventwithdrawal from the tips from the heart wall.

An expansive member such as one or more strands or swellable pads extendbetween at least one pair of adjacent ribs at or close to the outer edgeor periphery of the membrane to exert enough pressure to the flexiblemembrane periphery when the partitioning device is in an expandedconfiguration to ensure an adequate seal between the membrane peripheryand the lining of the heart wall. In one embodiment, a single strand orstrands extend around essentially the entire periphery of the membraneso that the flexible periphery of the membrane between each pair of ribsis effectively sealed against the heart wall. The expansive strand orstrands are formed of material which is stiffer than the flexible,unsupported material of the membrane to provide an outward expansiveforce or thrust to prevent formation of inwardly directed folds orwrinkles when the ribs of the partitioning device are in at least apartially contracted configuration. Suitable strand or strands areformed of material such as polypropylene suture or superelastic NiTialloy wires. Such strands are typically about 0.005 to about 0.03 inch(0.13-0.76 mm) in diameter to provide the requisite outward expansiveforce when placed in a circular position such as around the periphery ofthe membrane in less than completely expanded configuration.

In another embodiment expandable pads are provided between each adjacentpair of ribs which are configured to swell upon contact with body fluidsto provide an outward expansive force or thrust, as above, to preventformation of inwardly directed folds or wrinkles when the ribs of thepartitioning device are in at least a partially contractedconfiguration. Preferably the pads are formed of expansive hydrophilicfoam. Suitable swellable materials includable collagen, gelatin,polylactic acid, polyglycolic acid, copolymers of polylactic acid andpolyglycolic acid, polycaprolactone, mixtures and copolymers thereof.Other suitable swellable bioresorbable polymeric materials may beemployed. The expandable pads may be formed so as to delivery a varietyof therapeutic or diagnostic agents.

The ribs in their expanded configuration angle outwardly from the huband the free proximal ends curve outwardly so that the membrane securedto the ribs of the expanded frame forms a trumpet-shaped, pressurereceiving surface.

The partitioning membrane in the expanded configuration has radialdimensions from about 10 to about 160 mm, preferably about 25 to about50 mm, as measured from the center line axis. The membrane is preferablyformed of flexible material or fabric such as expandedpolytetrafluoroethylene (ePTFE).

The partitioning device is designed to be oversized with respect to thechamber in which it is to be deployed so that the ribs of the deviceapply an outward force against the chamber wall. When the partitioningdevice is collapsed for delivery, the outwardly biased strand or strandsensures that there are no inwardly directed folds or wrinkles and thatnone are formed when the partitioning device is expanded for deploymentwithin the heart chamber.

In one partitioning device design embodying features of the invention,the free ends of the expansive strand or strands may be secured togetheror to the partitioning device. Alternatively, in another device design,the expansive strand or strands may be long enough so that one or bothfree ends thereof extend out of the patient to facilitate collapse andretrieval of the partitioning device. Pulling on the free ends of thestrand extending out of the patient closes the expanded portion i.e. theribs and membrane, of the partitioning device to collapse of the deviceand such pulling can pull the collapsed partitioning device into theinner lumen of a guide catheter or other collecting device

The reinforced partitioning component preferably includes a supportingcomponent or stem which has a length configured to extend distally tothe heart wall surface to support the partitioning device within theheart chamber. The supporting component has a plurality of pods or feet,preferably at least three, which distribute the force of thepartitioning device about a region of the ventricular wall surface toavoid immediate or long term damage to the tissue of the heart wall,particularly compromised or necrotic tissue such as tissue of amyocardial infarct (MI) and the like. Pods of the support componentextend radially and preferably are interconnected by struts or planeswhich help distribute the force over an expanded area of the ventricularsurface.

The partitioning device may be delivered percutaneously orintraoperatively. One particularly suitable delivery catheter has anelongated shaft, a releasable securing device on the distal end of theshaft for holding the partitioning device on the distal end and anexpandable member such as an inflatable balloon on a distal portion ofthe shaft proximal to the distal end to press the interior of the recessformed by the pressure receiving surface to ensure that the tissuepenetrating tips or elements on the periphery of the partitioning devicepenetrate sufficiently into the heart wall to hold the partitioningdevice in a desired position to effectively partition the heart chamber.A suitable delivery device is described in co-pending application Ser.No. 10/913,608, filed on Aug. 5, 2004, and assigned to the presentassignee.

The partitioning device embodying features of the invention isrelatively easy to install and is a substantially improved treatment ofa diseased heart. A more normal diastolic and systolic movement of apatient's diseased heart is achieved. Concomitantly, an increase in theejection fraction of the patient's heart chamber is usually obtained.These and other advantages of the invention will become more apparentfrom the following detailed description of the invention and theaccompanying exemplary drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is an elevational view of a partitioning device embodyingfeatures of the invention in an expanded configuration.

FIG. 2 is a plan view of the partitioning device shown in FIG. 1illustrating the upper surface of the device.

FIG. 3 is bottom view of the partitioning device shown in FIG. 1.

FIG. 4 is a perspective view of the non-traumatic tip of the distallyextending stem of the device shown in FIG. 1.

FIG. 5 is a partial cross-sectional view of the hub of the partitioningdevice shown in FIG. 2 taken along the lines 5-5.

FIG. 6 is a transverse cross sectional view of the hub shown in FIG. 5taken along the lines 6-6.

FIG. 7 is a longitudinal view, partially in section of a reinforcing riband membrane at the periphery of the partitioning device shown in FIG.1.

FIG. 8 is a schematic elevational view, partially in section, of adelivery system with the partitioning device shown in FIGS. 1 and 2mounted thereon.

FIG. 9 is a transverse cross-sectional view of the delivery system shownin FIG. 8 taken along the lines 9-9.

FIG. 10 is an elevational view, partially in section, of the hub shownin FIG. 5 being secured to the helical coil of the delivery system shownin FIG. 8.

FIGS. 11A-11E are schematic views of a patient's left ventricularchamber illustrating the deployment of the partitioning device shown inFIGS. 1 and 2 with the delivery system shown in FIG. 8 to partition apatient's heart chamber (left ventricle) into a primary productiveportion and a secondary, non-productive portion.

FIG. 12 is a schematic plan view of the deployed device shown in FIG.11E within a patient's heart chamber.

FIG. 13 is a schematic plan view of the partitioning device shown inFIG. 1 without the expansive strand after deployment within a patient'sheart chamber.

FIG. 14 is a partial schematic view of the partitioning device shown inFIGS. 1 and 2 in a contracted configuration resulting from pulling thefree ends of the expansive strand at the periphery of the reinforcedmembrane.

FIG. 15 is a schematic view of the contracted device shown in FIG. 14being pulled into an expanded distal end of a receiving catheter tofacilitate withdrawal of the partitioning device into a receivingcatheter.

FIG. 16 is a schematic view of the contracted device shown in FIG. 14pulled further into the inner lumen of the receiving catheter.

FIG. 17 is a perspective view of the bottom of an alternativepartitioning device which has swellable pads disposed between adjacentribs to press the membrane between the ribs against the heart wall.

FIG. 18 is a perspective view of the top of the partitioning deviceshown in FIG. 17.

FIG. 19 is a cross-sectional view of a swellable pad disposed betweentwo membrane layers secured to the ribs of the partitioning device.

DETAILED DESCRIPTION OF EMBODIMENTS OF THE INVENTION

FIGS. 1-4 illustrate a partitioning device 10 which embodies features ofthe invention and which includes a partitioning membrane 11, a hub 12,preferably centrally located on the partitioning device, and a radiallyexpandable reinforcing frame 13 is secured to the proximal or pressureside of the frame 13 as shown in FIG. 1. The ribs 14 have distal ends 15which are secured to the hub 12 and free proximal ends 16 which areconfigured to curve or flare away from a center line axis. Radialexpansion of the free proximal ends 16 unfurls the membrane 11 securedto the frame 13 so that the membrane presents a pressure receivingsurface 17 which defines in part the productive portion of the patient'spartitioned heart chamber. The peripheral edge 18 of the membrane 11 maybe serrated as shown.

A continuous expansive strand 19 extends around the periphery of themembrane 11 on the pressure side thereof to apply pressure to thepressure side of the flexible material of the membrane to effectivelyseal the periphery of the membrane against the wall of the ventricularchamber. The ends 20 and 21 of the expansive strand 19 are shownextending away from the partitioning device in FIGS. 2 and 3. The ends20 and 21 may be left unattached or may be secured together, e.g. by asuitable adhesive or the membrane 11 itself. While not shown in detail,the membrane 11 has a proximal layer secured to the proximal faces ofthe ribs 14 and a distal layer secured to the distal faces of the ribsin a manner described in co-pending application Ser. No. 10/913,608,filed on Aug. 5, 2004.

The hub 12 shown in FIGS. 4 and 5 preferably is connected to anon-traumatic support component 22. The support component 22 has a stem23 a plurality of pods or feet 24 extending radially away from thecenter line axis and the ends of the feet 24 are secured to struts 25which extend between adjacent feet. A plane of material (not shown) mayextend between adjacent feet 24 in a web-like fashion to provide furthersupport in addition to or in lieu of the struts 25. The inner diameterof the stem 23 is threaded to secure the partitioning device 10 to adelivery catheter as shown in FIGS. 8-10.

As shown in FIG. 5, the distal ends 15 of the ribs 14 are secured withinthe hub 12 and, as shown in FIG. 6, a transversely disposed connectorbar 26 is secured within the hub which is configured to secure the hub12 to the nontraumatic support component 22.

As illustrated in FIGS. 5 and 6, the connector bar 26 of the hub 12allows the partitioning device 10 to be secured to the non-traumaticsupport component 22 and to be released from the delivery system withinthe patient's heart chamber. The distal ends 15 of the reinforcing ribs14 are secured within the hub 12 in a suitable manner or they may besecured to the surface defining the inner lumen or they may be disposedwithin channels or bores in the wall of the hub 12. The distal end ofthe ribs 14 are preshaped so that when the ribs are not constrained,other than by the membrane 11 secured thereto (as shown in FIGS. 1 and2), the free proximal ends 16 thereof expand to a desired angulardisplacement away from the centerline axis which is about 20° to about90°, preferably about 50° to about 80°. The unconstrained diameter ofthe partitioning device 10 should be greater than the diameter of theheart chamber at the deployed location of the partitioning device sothat an outward force is applied to the wall of the heart chamber by thepartially expanded ribs 14 during systole and diastole so that theresilient frame 13 augments the heart wall movement.

FIG. 7 illustrates the curved free proximal ends 16 of ribs 14 which areprovided with sharp tip elements 27 configured to engage and preferablypenetrate into the wall of the heart chamber and hold the partitioningdevice 10 in a deployed position within the patient's heart chamber soas to partition the ventricular chamber into a productive portion and anon-productive portion.

FIGS. 8-10 illustrate a suitable delivery system 30 delivering thepartitioning device 10 shown in FIGS. 1 and 2 into a patient's heartchamber and deploying the partitioning device to partition the heartchamber as shown in FIGS. 11A-11E. The delivery system 30 includes aguide catheter 31 and a delivery catheter 32.

The guide catheter 31 has an inner lumen 33 extending between theproximal end 34 and distal end 35. A hemostatic valve (not shown) may beprovided at the proximal end 34 of the guide catheter 31 to seal aboutthe outer shaft 37 of the delivery catheter 32. A flush port 36 on theproximal end 34 of guide catheter 31 is in fluid communication with theinner lumen 33.

The delivery catheter 32 has an outer shaft 37 with an adapter 38 on theproximal end thereof having a proximal injection port 39 which is influid communication with the interior of the shaft 37. As shown in moredetail in FIG. 9, the outer shaft 37 has an inner shaft 41 which isdisposed within the interior thereof and is secured to the inner surfaceof the outer shaft 37 by webs 43 which extend along a substantial lengthof the inner shaft. The injection port 39 is in fluid communication withthe passageways 42 between the inner and outer shafts 41 and 37respectively and defined in part by the webs 42. A torque shaft 44,which is preferably formed of hypotubing (e.g. formed of stainless steelor superelastic NiTi), is disposed within the inner lumen 45 of theinner shaft 41 and has a proximal end 46 secured within the adapter 38.Balloon inflation port 47 is in fluid communication with the inner lumen48 of the torque shaft 44. Torque shaft 44 is rotatably disposed withinthe inner lumen 45 of the inner shaft 41 and is secured to rotating knob49. A helical coil screw 50 is secured to the distal end 51 of thetorque shaft 44 and rotation of the torque knob 49 on the proximal end46 of the torque shaft 44 rotates the screw 51 to facilitate deploymentof a partitioning device 10. The proximal end 52 of inflatable balloon53 is sealingly secured by adhesive 54) about the torque shaft 44proximal to the distal end 51 of the torque shaft. The balloon 53 has aninterior 55 in fluid communication with the inner lumen 48 of the torqueshaft 44. Inflation fluid may be delivered to the balloon interior 55through port 47 which is in fluid communication with the inner lumen 48of the torque shaft 44. The distal end 56 of the balloon 53 is sealinglysecured by adhesive 57 to the helical screw 50. The proximal and distalends 52 and 56 of the balloon 53 are blocked by the adhesive masses 54and 57 to prevent the loss of inflation fluid delivered to the interior55 of the balloon 53. Delivery of inflation fluid through a fluiddischarge port 58 in the distal end 51 of the torque shaft 44 inflatesthe balloon 53 which in turn applies pressure to the proximal surface ofthe partitioning device 10 to facilitate securing the partitioningcomponent 10 to the wall 59 of heart chamber 60 as shown in FIGS.11A-11E discussed below.

As shown in FIG. 11A, the partitioning component 10 is delivered througha delivery system 30 which includes a guide catheter 31 and a deliverycatheter 32. The partitioning component 10 is collapsed in a first,delivery configuration which has small enough transverse dimensions tobe slidably advanced through the inner lumen 33 of the guide catheter31. Preferably, the guide catheter 31 has been previously percutaneouslyintroduced and advanced through the patient's vasculature, such as thefemoral artery, in a conventional manner to the desired heart chamber60. The delivery catheter 32 with the partitioning component 10 attachedis advanced through the inner lumen 33 of the guide catheter 31 untilthe partitioning component 10 is ready for deployment from the distalend of the guide catheter 31 into the patient's heart chamber 60 to bepartitioned.

As shown in FIG. 11B, the partitioning component 10 mounted on the screw50 is urged further out of the inner lumen 33 of the guide catheter 32until the support component 22 engages the heart wall 59. The guidecatheter 31 is withdrawn while the delivery catheter 32 is held in placeuntil the proximal ends 16 of the ribs 14 exit the distal end 35 of theguide catheter. As shown in FIG. 11C, the free proximal ends 16 of ribs14 expand outwardly to press the sharp proximal tips 27 of the ribs 14against and preferably into the tissue lining the heart wall 59.

With the partitioning component 10 deployed within the heart chamber 60and preferably partially secured therein, inflation fluid is introducedthrough the inflation port 58 in the distal end 51 torque shaft 44 whereit is directed into the balloon interior 54 to inflate the balloon 53.The inflated balloon 53 presses against the pressure receiving surface17 of the membrane 11 of the partitioning component 10 to ensure thatthe sharp proximal tips 27 are pressed well into the tissue lining theheart wall 59 as shown in FIG. 11D.

With the partitioning device 10 properly positioned within the heartchamber 60, the knob 49 on the torque shaft 44 (as shown in FIG. 8) isrotated counter-clockwise to disengage the helical coil screw 50 of thedelivery catheter 32 from the stem 23 secured within hub 12. Thecounter-clockwise rotation of the torque shaft 44 rotates the helicalcoil screw 50 which rides on the connector bar 26 secured within the hub12. Once the helical coil screw 50 disengages the connector bar 26, thedelivery system 30, including the guide catheter 31 and the deliverycatheter 32, may then be removed from the patient.

The proximal end 34 of the guide catheter 31 is provided with a flushport 36 to inject fluids such as therapeutic, diagnostic or other fluidsthrough the inner lumen 33 during the procedure. Similarly, the proximalinjection port 39 of adapter 38 is in communication with passageways 43if the delivery catheter 32 for essentially the same purpose.

The deployment of the partitioning component 10 in the patient's heartchamber 60 as shown in FIG. 11E divides the chamber into a mainproductive or operational portion 61 and a secondary, essentiallynon-productive portion 62. The operational portion 61 is smaller thanthe original heart chamber 60 and provides for an improved ejectionfraction and an improvement in blood flow. Over time, the non-productiveportion 62 fills first with thrombus and subsequently with cellulargrowth. Bio-resorbable fillers such as polylactic acid, polyglycolicacid, polycaprolactone and copolymers and blends may be employed toinitially fill the non-productive portion 62. Fillers may be suitablysupplied in a suitable solvent such as dimethylsulfoxide (DMSO). Othermaterials which accelerate tissue growth or thrombus may be deployed inthe non-productive portion 62 as well as non-reactive fillers.

FIG. 12 is a top view of the deployed partitioning device shown in FIG.11E schematically illustrating the sealed periphery of the membrane 11against the ventricular wall. This is to be compared with the schematicpresentation shown in FIG. 13 which illustrates a partitioning devicewithout a strand having folds along the periphery 18 which do not allowfor an effective seal against the wall 59 of the heart chamber 60.

The partitioning device 10 may be conveniently formed by the methoddescribed in co-pending application Ser. No. 10/913,608, filed on Aug.5, 2004, which is incorporated herein by reference.

While porous ePTFE material is preferred, the membrane 11 may be formedof suitable biocompatible polymeric material which includes Nylon, PET(polyethylene terephthalate) and polyesters such as Hytrel. The membrane11 may be foraminous in nature to facilitate tissue ingrowth afterdeployment within the patient's heart. The delivery catheter 32 and theguiding catheter 31 may be formed of suitable high strength polymericmaterial such as PEEK (polyetheretherketone), polycarbonate, PET, Nylon,and the like. Braided composite shafts may also be employed.

FIGS. 14-16 illustrate the collapse and retrieval of a partitioningdevice 10 by pulling on the ends 20 and 21 of the expansive strand 19which extends around the periphery of the membrane 11. Typically, thepartitioning device 10 would still be secured to the delivery catheter32, but the delivery catheter is not shown to simplify the drawings. InFIG. 14 the partitioning device 10 is shown in a partially collapsedconfiguration. In FIG. 15 the partially collapsed partitioning device 10is shown being withdrawn into the flared distal end 63 of retrievalcatheter 64. FIG. 16 illustrates the completely collapsed partitioningdevice 10 pulled further into the retrieval catheter 64. Thepartitioning device 10 may be withdrawn by pulling the device throughthe inner lumen 65 of the retrieval catheter 64. Optionally, thepartitioning device 10 and retrieval catheter may be withdrawn from thepatient together.

To assist in properly locating the device during advancement andplacement thereof into a patient's heart chamber, parts, e.g. the distalextremity, of one or more of the ribs 14 and/or the hub 12 may beprovided with markers at desirable locations that provide enhancedvisualization by eye, by ultrasound, by X-ray, or other imaging orvisualization means. Radiopaque markers may be made with, for example,stainless steel, platinum, gold, iridium, tantalum, tungsten, silver,rhodium, nickel, bismuth, other radiopaque metals, alloys and oxides ofthese metals.

FIGS. 17 and 18 illustrate an alternative design which embodies featuresof the invention in which the partitioning device 10 is provided withswellable bodies 70, preferably hydrophilic foam, around the peripheryof the membrane 11 between adjacent ribs 14. When these bodies contactbody fluid, such as blood, upon deployment, they swell, thereby sealingthe peripheral portion of the membrane 11 against the patient's heartwall as previously described. The details of the partitioning device 10are essentially the same as in the previous embodiment and elements inthis alternative embodiment are given the same reference numbers assimilar elements in the previous embodiments.

To the extent not otherwise described herein, the various components ofthe partitioning device and delivery system may be formed ofconventional materials and in a conventional manner as will beappreciated by those skilled in the art.

While particular forms of the invention have been illustrated anddescribed herein, it will be apparent that various modifications andimprovements can be made to the invention. Moreover, individual featuresof embodiments of the invention may be shown in some drawings and not inothers, but those skilled in the art will recognize that individualfeatures of one embodiment of the invention can be combined with any orall the features of another embodiment. Accordingly, it is not intendedthat the invention be limited to the specific embodiments illustrated.It is intended that this invention to be defined by the scope of theappended claims as broadly as the prior art will permit.

Terms such a “element”, “member”, “component”, “device”, “section”,“portion”, “step”, “means” and words of similar import, when used hereinshall not be construed as invoking the provisions of 35 U.S.C. §112(6)unless the following claims expressly use the term “means” followed by aparticular function without specific structure or the term “step”followed by a particular function without specific action. Accordingly,it is not intended that the invention be limited, except as by theappended claims. All patents and patent applications referred to hereinare hereby incorporated by reference in their entirety.

1. A device for treating a patient's heart by partitioning a chamber ofthe patient's heart into a primary productive portion and a secondarynon-productive portion, comprising: a. a reinforced membrane which formsa recess when in an expanded deployed configuration; and b. at least oneoutwardly biased member which is secured to a peripheral portion of themembrane so as to seal the peripheral portion of the membrane against aventricular wall surface defining in part the patient's heart chamber.2. The device of claim 1 wherein the membrane is reinforced with anexpandable frame.
 3. The device of claim 2 wherein the expandable frameis formed of a plurality of ribs having secured first ends and freesecond ends.
 4. The device of claim 1 wherein the membrane is formed atleast in part of flexible material.
 5. The device of claim 3 wherein atleast one outwardly biased member is secured to the peripheral portionof the flexible membrane extending between adjacent ribs.
 6. The deviceof claim 3 wherein the reinforced membrane has a first membrane layersecured to proximal faces of the ribs.
 7. The device of claim 6 whereinthe reinforced membrane has a second membrane layer secured to distalfaces of the ribs.
 8. The device of claim 1 wherein outwardly biasedmembers extend about essentially the entire peripheral portion of themembrane.
 9. The device of claim 1 wherein the at least one outwardlybiased member is a strand.
 10. The device of claim 9 wherein the strandis formed of suture material.
 11. The device of claim 9 wherein thestrand is formed of polypropylene or superelastic NiTi alloy.
 12. Thedevice of claim 1 wherein the one or more outwardly biased members areswellable bodies on the periphery of the membrane.
 13. The device ofclaim 12 wherein the swellable body is formed of a bioabsorbablematerial.
 14. The device of claim 13 wherein the bioabsorbable materialis selected from the group consisting of collagen, gelatin, polylacticacid, polyglycolic acid, copolymers of polylactic acid and polyglycolicacid, polycaprolactone, mixtures and copolymers thereof
 15. The deviceof claim 1 wherein a first outwardly biased member extends between afirst pair of adjacent ribs and a second outwardly biased member extendsbetween a second pair of adjacent ribs.
 16. The device of claim 1wherein the first ends of the ribs are secured to a central hub.
 17. Thedevice of claim 3 wherein the free end of at least one of the ribs has atissue penetrating securing element.
 18. The device of claim 3 whereinthe free end of at least one of the ribs are outwardly curved.
 19. Thedevice of claim 18 wherein the outwardly curved free proximal ends ofthe ribs have tips which penetrate tissue lining the heart chamber at anangle of not more than 45° away from a center line axis of thepartitioning device.
 20. The device of claim 1 wherein the secureddistal ends of the ribs are configured to facilitate abduction of thefree proximal ends of the ribs away from a centerline axis to facilitateexpansion of the reinforced partitioning component to an expandedconfiguration to facilitate deployment within the patient's heartchamber.
 21. The device of claim 6 wherein the first membrane layer isconfigured to receive pressure.
 22. The device of claim 6 wherein thefirst membrane layer has a pressure receiving surface with radialdimensions from a center line axis of about 5 to about 80 mm.
 23. Thedevice of claim 6 wherein the first membrane layer has a pressurereceiving surface with radial dimensions from a center line axis ofabout 5 to about 80 mm.
 24. The device of claim 2 wherein the expandableframe has about 3 to about 30 ribs.
 25. The device of claim 2 whereinthe expandable frame has about 6 to about 16 ribs.
 26. The device ofclaim 2 wherein the expandable frame is self expanding.
 27. The deviceof claim 26 wherein the ribs of the expandable frame are formed ofsuperelastic NiTi alloy which is in an austenite phase when unstressedat body temperature.
 28. The device of claim 2 wherein ribs of theexpandable frame have a contracted configuration for delivery topatient's heart chamber to be partitioned.
 29. The device of claim 28wherein the ribs of the expandable frame are at least in part in astress maintained martensite phase when in the contracted configuration.30. The device of claim 28 wherein the ribs of the expandable frame areat least in part in an austenite phase when deployed within thepatient's heart chamber.
 31. The device of claim 4 wherein the flexiblematerial of the reinforced membrane is formed at least in part ofexpanded fluoropolymer.
 32. The device of claim 31 wherein the expandedfluoropolymer is expanded polytetrafluoroethylene.
 33. The device ofclaim 2 wherein the expandable frame has a central hub and the firstends of the ribs are secured to the central hub.
 34. The device of claim33 wherein the central hub has a stem with a non-traumatic distal tipconfigured to engage a region of a ventricular wall defining in part thenon-productive portion thereof.
 35. The device of claim 34 wherein thenon-traumatic distal tip has at least three feet that extend radiallyfrom a centerline axis.
 36. The device of claim 35 wherein feet of thenon-traumatic distal tip have ends that are flexibly interconnected. 37.The device of claim 36 wherein the ends of the feet are flexiblyinterconnected by struts or webs.
 38. The device of claim 36 wherein theends of the feet are in an essentially common plane.
 39. A device fortreating a patient's heart by partitioning a chamber of the patient'sheart into a primary productive portion and a secondary non-productiveportion, comprising: a. a reinforced membrane which forms a recess whenin an expanded deployed configuration and which is formed at least inpart of flexible material; and b. a distally extending supporting stemelement which has a plurality of radially extending feet that have endsthat are interconnected.
 40. The device of claim 39 wherein the distallyextending supporting stem element has at least three feet configured tonon-traumatically engage a wall surface defining in part the secondarynon-productive portion of the heart chamber.
 41. A device for treating apatient with congestive heart failure by partitioning a chamber of thepatient's heart into a primary productive portion and a secondarynon-productive portion, comprising: a. a partitioning component whichhas an expandable frame formed of a plurality of ribs having distal endssecured to a central hub and free outwardly flared proximal ends andwhich has a pressure receiving membrane formed at least in part offlexible material forming a recess in an expanded, deployedconfiguration defining in part the primary productive portion of thepatient's heart chamber to be partitioned; and b. an outwardly biasedmember which is secured to the periphery of the membrane so as to sealthe periphery of the membrane against a ventricular wall surfacedefining in part the heart chamber.
 42. The device of claim 41 whereinthe outwardly biased member is an elongated strand.
 43. The device ofclaim 41 wherein the strand extends about essentially the entiremembrane periphery.
 44. The device of claim 41 wherein the outwardlybiased strand extends between adjacent ribs of the expandable frame. 45.The device of claim 41 wherein the outwardly biased member is aswellable body,
 46. The device of claim 45 wherein the swellable body ishydrophilic.
 47. The device of claim 41 wherein the flexible material ofthe membrane is formed at least in part of a polymeric fabric.
 48. Thedevice of claim 41 wherein the flexible material of the membrane isformed at least in part of expanded fluoropolymer.
 49. The device ofclaim 48 wherein the expanded fluoropolymer is polytetrafluoroethylene.50. A partitioning apparatus for a patient's heart chamber to improvecardiac function thereof, comprising: a. a central hub component; b. anexpandable frame component having a plurality of ribs with free,outwardly flared proximal ends and distal ends secured to the centralhub component; c. a membrane component secured to the expandable frameribs which defines a recessed, pressure receiving surface; and d. asupporting stem element which extends distally from the central hub andwhich has a plurality of radially extending feet that have ends that areflexibly interconnected.
 51. The partitioning apparatus of claim 50wherein the distally extending stem element has at least three feetconfigured to non-traumatically engage a wall surface defining in partthe secondary non-productive portion of the heart chamber.